Week 4 of my ortho ip placement (Final Ax). I treated a 48 y.o male who has a # L tibfib as a result of a fall. He has to remain NWB for 6/52. He is a construction worker. When his PCA was removed, I took him to the gym to try him out on crutches. He said he doesn't need to be taught how to use the crutches as he has used them before, I insisted and said that I need to review his mobility before the doctors decide to discharge him. I gave him brief instructions on using the crutches. When he stood up he didn't wait for my command and began ambulating. He got the sequence of movement right, but it seems to me that he was rushing through movement and is potentially unsafe, I had to keep telling him to slow down. I taught him how to get up and down stairs the same day. He didn't have trouble with that either but he was rushing through the movement as well. He managed the stairs safely but its a falls risk if he rushes through the movement and i explained that to him. My supervisor was there with me and she told him that 'if you fall here, you will have to stay longer in the hospital' and he slowed down. I took him back to his room and wrote in his progress notes that he is currently ambulating independently and is safe to go home. Despite him being potentially unsafe, I thought that given he is a 48 y.o. construction worker who is physically fit and able, and it is in his nature to tend to rush things and just want to get things done quickly. My supervisor told me that it was good that i managed to keep calm and be appropriately assertive with the patient but to actually get this patient to be compliant I will have to tell him the consequence of his action and be more than 'appropriately assertive'.
From this experience I have learn that sometimes we just have to adjust to our patients behavior and alter our sessions and judgments regarding their safety accordingly.
From this experience I have learn that sometimes we just have to adjust to our patients behavior and alter our sessions and judgments regarding their safety accordingly.
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